The importance of addiction medications

It's not "replacing one addiction with another." It's an evidence-based treatment that's proven to save lives, reduce relapse, and help people live happy, healthy lives.

Using medications for addiction treatment (MAT) is often misunderstood. Stigma and misconception have led many to believe this form of treatment is “replacing one addiction with another,” or that people who use medications to treat their addiction are “not really in recovery.” But these false representations of a medical therapy contradict the extensive body of scientific evidence on the treatment of substance use disorders and on chronic disease management in general.

Substance use disorders are chronic brain diseases linked to the recurrent use of drugs, and, like other diseases, exist on a spectrum from mild to severe. When the drug being used is opioids, it is called opioid use disorder (OUD), and when the disease is “severe,” it’s what most people call addiction. Addiction rewires the brain so that those who are addicted need higher doses of the drug to feel normal, and affects executive functions that impact self-control and decision-making. This creates a pathological need for compulsive drug use, even if that drug use is harming the individual or their loved ones.

Just like with other chronic diseases, medications are appropriate for treating some substance use disorders. There are currently three medications approved by the U.S. Food and Drug Administration to treat OUD: methadone, buprenorphine, and naltrexone, also known under brand name formulations like Suboxone and Vivitrol. These medications work by regulating brain chemistry and bodily functions , and blocking the effects of other drugs. Medications can ease symptoms of withdrawal , reduce cravings, and restore normal brain function, which allows the patient to work and live a normal life.

When appropriately prescribed and monitored, MAT is effective in treating OUD. It also reduces overdose risk and improves both long-term recovery and other health outcomes. MAT substantially increases the likelihood that a patient will reduce or stop using opioids , and remain in treatment. Research shows that using MAT for opioid addiction decreases the risk of death due to opioid use by at least 50%. MAT also positively impacts patients’ behavior, reducing their risk of becoming infected with HIV or hepatitis C.

Patients being treated by MAT are dependent on their medication as an important part of their routine. However, this does not mean they are addicted to the medication. Addiction and dependence are not synonymous—those dependent on a medication or drug will suffer from physical withdrawal if the drug is taken away. On the other hand, in addiction the individual’s brain has been rewired to create a compulsive need for the drug, despite harm. Many patients using MAT require their medication to function, in much the same way a person with diabetes requires insulin. But, just like that person with diabetes, their use of medication is not an addiction.

Despite substantial evidence that MAT is effective, the misconception that it is another form of addiction has prevented this treatment from being more widely available. In the U.S., there are currently at least 1 million people in need of MAT who are not receiving it. This compelling need for action is why access to MAT is one of Shatterproof’s National Principles of Care for substance use disorder treatment. These core concepts of quality addiction treatment are the foundation for the initiatives of our movement to transform addiction treatment in America .

Shatterproof joins the American Medical Association (AMA) , the American Academy of Addiction Psychiatry (AAAP) , the American Society of Addiction Medicine (ASAM) and many other key stakeholders in supporting MAT, and working to make it more widely available.

The stigma and misconceptions around MAT must be corrected. This life-saving medical treatment must be widely accepted and made available as a critical component to slow the opioid epidemic.

Shatterproof will continue to correct misinformation on MAT and support work to ensure this treatment is readily available, covered by insurance without arbitrary restrictions, and valued by recovery groups.

Shatterproof is taking direct action to establish a national standard of care that includes MAT—learn more by reading about our National Treatment Quality Initiatives.

September 2021

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